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Risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed COVID‐19: A retrospective cohort study

OBJECTIVE: To investigate factors contributing to excess deaths of older patients during the initial 2020 lockdown beyond those attributable to confirmed COVID‐19. METHODS: Retrospective cohort study comparing patients treated between 23 March 2020 and 14 June 2020, deemed exposed to the pandemic/lo...

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Autores principales: Chen, Shanquan, Jones, Peter B., Underwood, Benjamin R., Fernandez‐Egea, Emilio, Qin, Pei, Lewis, Jonathan R., Cardinal, Rudolf N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8420159/
https://www.ncbi.nlm.nih.gov/pubmed/34382242
http://dx.doi.org/10.1002/gps.5610
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author Chen, Shanquan
Jones, Peter B.
Underwood, Benjamin R.
Fernandez‐Egea, Emilio
Qin, Pei
Lewis, Jonathan R.
Cardinal, Rudolf N.
author_facet Chen, Shanquan
Jones, Peter B.
Underwood, Benjamin R.
Fernandez‐Egea, Emilio
Qin, Pei
Lewis, Jonathan R.
Cardinal, Rudolf N.
author_sort Chen, Shanquan
collection PubMed
description OBJECTIVE: To investigate factors contributing to excess deaths of older patients during the initial 2020 lockdown beyond those attributable to confirmed COVID‐19. METHODS: Retrospective cohort study comparing patients treated between 23 March 2020 and 14 June 2020, deemed exposed to the pandemic/lockdown, to patients treated between 18 December 2019 and 10 March 2020, deemed to be unexposed. Data came from electronic clinical records from secondary care mental health services in Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK (catchment area population ∼0.86 million). Eligible patients were aged 65 years or over at baseline with at least 14 days' follow‐up, excluding patients diagnosed with confirmed or suspected SARS‐CoV‐2 infection. The primary outcome was all‐cause mortality. FINDINGS: In the two cohorts, 3,073 subjects were exposed to lockdown and 4,372 subjects were unexposed; the cohorts were followed up for an average of 74 and 78 days, respectively. After controlling for confounding by sociodemographic factors, smoking status, mental comorbidities, and physical comorbidities, patients with dementia suffered an additional 53% risk of death (HR = 1.53, 95% CI = 1.02–2.31), and patients with severe mental illness suffered an additional 123% risk of death (HR = 2.23, 95% CI = 1.42–3.49). No significant additional mortality risks were identified from physical comorbidities, potentially due to low statistical power in that respect. CONCLUSION: During lockdown people with dementia or severe mental illness had a higher risk of death without confirmed COVID‐19. These data could inform future health service responses and policymaking to help prevent avoidable excess death during future outbreaks of this or a similar infectious disease.
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spelling pubmed-84201592021-09-07 Risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed COVID‐19: A retrospective cohort study Chen, Shanquan Jones, Peter B. Underwood, Benjamin R. Fernandez‐Egea, Emilio Qin, Pei Lewis, Jonathan R. Cardinal, Rudolf N. Int J Geriatr Psychiatry Research Articles OBJECTIVE: To investigate factors contributing to excess deaths of older patients during the initial 2020 lockdown beyond those attributable to confirmed COVID‐19. METHODS: Retrospective cohort study comparing patients treated between 23 March 2020 and 14 June 2020, deemed exposed to the pandemic/lockdown, to patients treated between 18 December 2019 and 10 March 2020, deemed to be unexposed. Data came from electronic clinical records from secondary care mental health services in Cambridgeshire and Peterborough NHS Foundation Trust (CPFT), UK (catchment area population ∼0.86 million). Eligible patients were aged 65 years or over at baseline with at least 14 days' follow‐up, excluding patients diagnosed with confirmed or suspected SARS‐CoV‐2 infection. The primary outcome was all‐cause mortality. FINDINGS: In the two cohorts, 3,073 subjects were exposed to lockdown and 4,372 subjects were unexposed; the cohorts were followed up for an average of 74 and 78 days, respectively. After controlling for confounding by sociodemographic factors, smoking status, mental comorbidities, and physical comorbidities, patients with dementia suffered an additional 53% risk of death (HR = 1.53, 95% CI = 1.02–2.31), and patients with severe mental illness suffered an additional 123% risk of death (HR = 2.23, 95% CI = 1.42–3.49). No significant additional mortality risks were identified from physical comorbidities, potentially due to low statistical power in that respect. CONCLUSION: During lockdown people with dementia or severe mental illness had a higher risk of death without confirmed COVID‐19. These data could inform future health service responses and policymaking to help prevent avoidable excess death during future outbreaks of this or a similar infectious disease. John Wiley and Sons Inc. 2021-08-19 2021-12 /pmc/articles/PMC8420159/ /pubmed/34382242 http://dx.doi.org/10.1002/gps.5610 Text en © 2021 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Chen, Shanquan
Jones, Peter B.
Underwood, Benjamin R.
Fernandez‐Egea, Emilio
Qin, Pei
Lewis, Jonathan R.
Cardinal, Rudolf N.
Risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed COVID‐19: A retrospective cohort study
title Risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed COVID‐19: A retrospective cohort study
title_full Risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed COVID‐19: A retrospective cohort study
title_fullStr Risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed COVID‐19: A retrospective cohort study
title_full_unstemmed Risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed COVID‐19: A retrospective cohort study
title_short Risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed COVID‐19: A retrospective cohort study
title_sort risk factors for excess deaths during lockdown among older users of secondary care mental health services without confirmed covid‐19: a retrospective cohort study
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8420159/
https://www.ncbi.nlm.nih.gov/pubmed/34382242
http://dx.doi.org/10.1002/gps.5610
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